What form cues are appropriate for avoiding overuse of pelvic muscles and pelvic floor tightness?

I have a new client who is being treated by a physical therapist for pelvic floor tightness. She wants me to help her to use correct form so that she does not overuse her pelvic muscles. Although I am pretty good with form, I'm not sure what exactly to look for in this case.

Answers (6)

I'm shocked that people aren't seeing and talking about this a bunch more. Pelvic Floor issues are extremely common. I personally don't have kids yet so I too was previously unaware until doing some continuing ed for my Pilates cert. In Pilates we have a lot more concern with the pelvic floor than other many other disciplines. I know when I started actually talking to my clients about their pelvic floors and urine leaking (i.e. when jumping, running, sneezing etc.) most of my female clients who have had kids are experiencing at least some level of stress incontinence which can be treated with exercise. I bet most of your clients are too, even the really fit ones i.e. check out "Do you pee during workouts?" clip from the crossfit games http://games.crossfit.com/video/do-you-pee-during-workouts

First some basic info copied from University of Chicago Medicine website:

Q. What is the pelvic floor?
A. Both men and women have a pelvic floor. In women, the pelvic floor is the muscles, ligaments, connective tissues and nerves that support the bladder, uterus, vagina and rectum and help these pelvic organs function. In men, the pelvic floor includes the muscles, tissues and nerves that support the bladder, rectum and other pelvic organs.

For many people, particularly women, the pelvic floor does not work as well as it should. Almost one-quarter of women face pelvic floor disorders, according to a study funded the National Institutes of Health. The study found that pelvic floor disorders affect about 10 percent of women ages 20 to 39, 27 percent of women ages 40 to 59, 37 percent of women ages 60 to 79 and nearly half of women age 80 or older.

Q. What are pelvic floor disorders?
A. Pelvic floor disorders occur when the "sling" or "hammock" that supports the pelvic organs becomes weak or damaged. The three main types of pelvic floor disorders are:
•Urinary incontinence, or lack of bladder control
•Fecal incontinence, or lack of bowel control
•Pelvic organ prolapse, a condition in which the uterus, bladder and bowel may "drop" onto the vagina and cause a bulge through the vaginal canal

Q. What are the symptoms of pelvic floor disorders?
A. People with pelvic floor disorders may experience:
•Urinary problems, such as an urgent need to urinate, painful urination or incomplete emptying of their bladder
•Constipation, straining or pain during bowel movements
•Pain or pressure in the vagina or rectum
•A heavy feeling in the pelvis or a bulge in the vagina or rectum
•Muscle spasms in the pelvis

Q. Are pelvic floor disorders a normal part of aging?
A. While pelvic floor disorders become more common as women get older, they are not a normal or acceptable part of aging. These problems can have a significant impact on a person’s quality of life. Fortunately, these disorders often can be reversed with treatment.

Q. What causes pelvic floor disorders?
A. Childbirth is one of the main causes of pelvic floor disorders. A woman’s risk tends to increase the more times she has given birth.

Women who are overweight or obese also have a greater risk for pelvic floor disorders.

Having pelvic surgery or radiation treatments also can cause these disorders. For example, these treatments can damage nerves and other tissues in the pelvic floor.

Other factors that can increase the risk include repeated heavy lifting or even genes.

There are medical specialists like urogynocologists who specialize in treating the pelvic floor and also physical therapists available who can assist in retraining these muscles with ultrasound and biofeedback. This should probably be the first stop for clients with pelvic floor issues which sounds like what Krista's client is doing.

Now to answer your question Krista is a little complicated. Pelvic floor muscles are just like any other muscles. The predominantly need to be endurance muscles as generally we'd like our pelvic organs to be supported 24/7 and not pop out. However they need to occasionally fire harder like when you are jumping or sneezing in order to prevent urine leakage. Generally when we lift weights etc. we should fire our stabilizing muscles like the pelvic floor and transverse abdominus first and then fire the movers. We release the weight they should also release. Some people fire and then don't release which can cause spasm so cue both the contract and release. Hope that helps some. As a general question would more info on the pelvic floor be helpful to people. I've thought of proposing an article or workshop and would curious if people are interested in the subject.

I'm not sure either, but it might be a good idea to consult with her physical therapist (since she is been currently treated by him/her) or even better with her doctor. Maybe you can find some information online (below are a couple links I found online):

Thanks for all the info! I'll be making sure to have her PT help guide me with this. I let her know her condition wasn't so common so I'd need the expertise from her PT. When we worked out today, simply asking her to focus on pushing through the heels and sitting back in her squat helped reduce pain/tension.